医护一体化专项管理模式在穿支皮瓣修复慢性创面患者护理中的应用

Application of Doctor-nurse Integration Specialized Management in Nursing Care of Patients with Chronic Wounds Repaired by Perforator Flap

目的:探讨医护一体化专项管理模式在穿支皮瓣修复慢性创面患者护理中的应用。方法:2016年6月-2020年5月随机选择88例穿支皮瓣修复慢性创面患者为研究对象,随机分为两组,各44例,对照组采用常规护理,观察组实施医护一体化专项管理,比较两组护理后创面恢复情况、医嘱依从性、焦虑状态及护理满意度情况。结果:观察组患者术后肉芽覆盖、肉芽愈合时间均显著低于对照组,差异有统计学意义(P<0.05)。观察组患者饮食控制、适当运动、定期复查3个方面的医嘱依从率均显著高于对照组,差异有统计学意义(P<0.05)。护理后3个月,两组焦虑自评量表(Self-rating anxiety scale,SAS)和汉密尔顿焦虑自评量表(Hamilton anxiety scale,HAMA)评分均显著低于护理前,其中,观察组SDS、HAMA评分均显著低于对照组,差异有统计学意义(P<0.05)。观察组患者在护理人员沟通能力、操作技能和医护配合度3个方面的护理满意度得分均高于对照组,差异有统计学意义(P<0.05)。结论:医护一体化专项管理有利于加快穿支皮瓣修复慢性创面患者的伤口恢复,安抚其焦虑情绪,医嘱依从性和护理满意度更高。

Objective To explore the application of doctor-nurse integration specialized management in the nursing of patients with chronic wounds repaired by perforator flap.Methods During the period from June 2016 to May 2020,88 patients with chronic wounds repaired by perforator flap were enrolled and randomly divided into the control group(routine nursing)and the observation group(doctor-nurse integration specialized management),44 cases in each group.The wound recovery,treatment compliance,anxiety status and scores of nursing satisfaction after nursing were compared between the two groups.Results After surgery,granulation coverage time and granulation healing time in the observation group were significantly shorter than those in the control group,the differences were statistically significant(P<0.05).The treatment compliance rates in terms of diet control,proper exercise and regular reexamination in the observation group were significantly higher than those in the control group(P<0.05).After 3 months of nursing,scores of Self-rating anxiety scale(SAS)and Hamilton anxiety scale(HAMA)were significantly lower than those before nursing in both groups,which were significantly lower in the observation group than the control group(P<0.05).The scores of patients’nursing satisfaction with communication ability,operating skills and medical cooperation in the observation group were significantly higher than those in the control group(P<0.05).Conclusion The doctor-nurse integration specialized management is beneficial to accelerate wound recovery of patients with chronic wounds undergoing perforator flap repair,soothe their anxiety,with higher treatment compliance and nursing satisfaction.